Chapter 100 Oregon Laws 2001

AN ACT

HB 2241

Relating to renal dialysis facilities; amending ORS 441.020 and 442.015.

Be It Enacted by the People of the State of Oregon:

SECTION 1. ORS 442.015 is amended to read:

442.015. As used in ORS chapter 441 and this chapter, unless the context requires otherwise:

(1) “Adjusted admission” means the sum of all inpatient admissions divided by the ratio of inpatient revenues to total patient revenues.

(2) “Affected persons” has the same meaning as given to “party” in ORS 183.310 (6).

(3) “Acquire” or “acquisition” refers to obtaining equipment, supplies, components or facilities by any means, including purchase, capital or operating lease, rental or donation, with intention of using such equipment, supplies, components or facilities to provide health services in Oregon. When equipment or other materials are obtained outside of this state, acquisition is considered to occur when the equipment or other materials begin to be used in Oregon for the provision of health services or when such services are offered for use in Oregon.

(4) “Audited actual experience” means data contained within financial statements examined by an independent, certified public accountant in accordance with generally accepted auditing standards.

(5) “Budget” means the projections by the hospital for a specified future time period of expenditures and revenues with supporting statistical indicators.

(6) “Case mix” means a calculated index for each hospital, based on financial accounting and case mix data collection as set forth in ORS 442.425, reflecting the relative costliness of that hospital's mix of cases compared to a state or national mix of cases.

(7) “Council” means the Oregon Health Council.

(8) “Department” means the Department of Human Services of the State of Oregon.

(9) “Develop” means to undertake those activities which on their completion will result in the offer of a new institutional health service or the incurring of a financial obligation, as defined under applicable state law, in relation to the offering of such a health service.

(10) “Director” means the Director of Human Services.

(11) “Expenditure” or “capital expenditure” means the actual expenditure, an obligation to an expenditure, lease or similar arrangement in lieu of an expenditure, and the reasonable value of a donation or grant in lieu of an expenditure but not including any interest thereon.

(12) “Governmental unit” means the state, or any county, municipality or other political subdivision, or any related department, division, board or other agency.

(13) “Gross revenue” means the sum of daily hospital service charges, ambulatory service charges, ancillary service charges and other operating revenue. “Gross revenue” does not include contributions, donations, legacies or bequests made to a hospital without restriction by the donors.

(14) “Health care facility” means:

(a) A “hospital” with an organized medical staff, with permanent facilities that include inpatient beds, and with medical services, including physician services and continuous nursing services under the supervision of registered nurses, to provide diagnosis and medical or surgical treatment primarily for but not limited to acutely ill patients and accident victims, or to provide treatment for the mentally ill or to provide treatment in special inpatient care facilities. A “special inpatient care facility” is a facility with permanent inpatient beds and other facilities designed and utilized for special health care purposes, to include but not limited to: Rehabilitation center, college infirmary, chiropractic facility, facility for the treatment of alcoholism or drug abuse, or inpatient care facility meeting the requirements of ORS 441.065, and any other establishment falling within a classification established by the division, after determination of the need for such classification and the level and kind of health care appropriate for such classification.

(b) A “long term care facility” with permanent facilities that include inpatient beds, providing medical services, including nursing services but excluding surgical procedures except as may be permitted by the rules of the director, to provide treatment for two or more unrelated patients. “Long term care facility” includes the terms “skilled nursing facility” and “intermediate care facility,” but such definition shall not be construed to include facilities licensed and operated pursuant to ORS 443.400 to 443.455. Such definitions shall include:

(A) A “skilled nursing facility” whether an institution or a distinct part of an institution, which is primarily engaged in providing to inpatients skilled nursing care and related services for patients who require medical or nursing care, or rehabilitation services for the rehabilitation of injured, disabled or sick persons.

(B) An “intermediate care facility” which provides, on a regular basis, health-related care and services to individuals who do not require the degree of care and treatment which a hospital or skilled nursing facility is designed to provide, but who because of their mental or physical condition require care and services above the level of room and board which can be made available to them only through institutional facilities.

(c) An “ambulatory surgical center” means a health care facility which performs outpatient surgery not routinely or customarily performed in a physician's or dentist's office, and is able to meet health facility licensure requirements.

(d) An establishment furnishing primarily domiciliary care is not a “health care facility.”

(e) A “health care facility” does not mean an establishment furnishing residential care or treatment not meeting federal intermediate care standards, not following a primarily medical model of treatment, prohibited from admitting persons requiring 24-hour nursing care and licensed or approved under the rules of the Mental Health and Developmental Disability Services Division, Senior and Disabled Services Division, State Office for Services to Children and Families, Department of Corrections or Vocational Rehabilitation Division.

(f) A “freestanding birthing center” means a health care facility licensed for the primary purpose of performing low risk deliveries.

(g) An “outpatient renal dialysis facility” that provides renal dialysis services directly to outpatients.

(15) “Health maintenance organization” or “HMO” means a public organization or a private organization organized under the laws of any state which:

(a) Is a qualified HMO under section 1310 (d) of the U.S. Public Health Services Act; or

(b)(A) Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services: Usual physician services, hospitalization, laboratory, X-ray, emergency and preventive services, and out-of-area coverage;

(B) Is compensated, except for copayments, for the provision of the basic health care services listed in subparagraph (A) of this paragraph to enrolled participants on a predetermined periodic rate basis; and

(C) Provides physicians' services primarily directly through physicians who are either employees or partners of such organization, or through arrangements with individual physicians or one or more groups of physicians organized on a group practice or individual practice basis.

(16) “Health services” means clinically related diagnostic, treatment or rehabilitative services, and includes alcohol, drug or controlled substance abuse and mental health services that may be provided either directly or indirectly on an inpatient or ambulatory patient basis.

(17) “Institutional health services” means health services provided in or through health care facilities and includes the entities in or through which such services are provided.

(18) “Medically indigent” means a person who has insufficient resources or assets to pay for needed medical care without utilizing resources required to meet basic needs for shelter, food and clothing.

(19) “Net revenue” means gross revenue minus deductions from revenue.

(20) “New hospital” means a facility that did not offer hospital services on a regular basis within its service area within the prior 12-month period and is initiating or proposing to initiate such services. “New hospital” also includes any replacement of an existing hospital that involves a substantial increase or change in the services offered.

(21) “New skilled nursing or intermediate care service or facility” means a service or facility that did not offer long term care services on a regular basis by or through the facility within the prior 12-month period and is initiating or proposing to initiate such services. A “new skilled nursing or intermediate care service or facility” also includes the rebuilding of a long term care facility, the relocation of buildings which are a part of a long term care facility, the relocation of long term care beds from one facility to another or an increase in the number of beds of more than 10 or 10 percent of the bed capacity, whichever is the lesser, within a two-year period.

(22) “Major medical equipment” means medical equipment which is used to provide medical and other health services and which costs more than $1 million. “Major medical equipment” does not include medical equipment acquired by or on behalf of a clinical laboratory to provide clinical laboratory services, if the clinical laboratory is independent of a physician's office and a hospital and has been determined under Title XVIII of the Social Security Act to meet the requirements of paragraphs (10) and (11) of section 1861(s) of that Act.

(23) “Offer” means that the health care facility holds itself out as capable of providing, or as having the means for the provision of, specified health services.

(24) “Operating expenses” means the sum of daily hospital service expenses, ambulatory service expenses, ancillary expenses and other operating expenses, excluding income taxes.

(25) “Person” means an individual, a trust or estate, a partnership, a corporation (including associations, joint stock companies and insurance companies), a state, or a political subdivision or instrumentality, including a municipal corporation, of a state.

(26) “State agency” means the office of the Director of Human Services.

(27) “Total deductions from gross revenue” or “deductions from revenue” means reductions from gross revenue resulting from inability to collect payment of charges. Such reductions include bad debts; contractual adjustments; uncompensated care; administrative, courtesy and policy discounts and adjustments and other such revenue deductions. The deduction shall be net of the offset of restricted donations and grants for indigent care.

SECTION 2. ORS 441.020 is amended to read:

441.020. (1) Licenses for health care facilities except long term care facilities, as defined in ORS 442.015, shall be obtained from the Health Division.

(2) Licenses for long term care facilities shall be obtained from the Senior and Disabled Services Division.

(3) Applications shall be upon such forms and shall contain such information as the appropriate division may reasonably require, which may include affirmative evidence of ability to comply with such reasonable standards and rules as may lawfully be prescribed under ORS 441.055.

(4) Each application shall be accompanied by the license fee. If the license is denied, the fee shall be refunded to the applicant. If the license is issued, the fee shall be paid into the State Treasury to the credit of the appropriate division for carrying out the functions under ORS 441.015 to 441.063 and 431.607 to 431.619.

(5) Except as otherwise provided in subsection (6) of this section, for hospitals with:

(a) Fewer than 26 beds, the annual license fee shall be $750.

(b) Twenty-six beds or more but fewer than 50 beds, the annual license fee shall be $1,000.

(d) One hundred beds or more but fewer than 200 beds, the annual license fee shall be $2,900.

(e) Two hundred or more beds, the annual license fee shall be $3,400.

(6) For long term care facilities with:

(a) Fewer than 16 beds, the annual license fee shall be up to $120.

(b) Sixteen beds or more but fewer than 50 beds, the annual license fee shall be up to $175.

(d) One hundred beds or more but fewer than 200 beds, the annual license fee shall be up to $450.

(e) Two hundred beds or more, the annual license fee shall be up to $580.

(7) For special inpatient care facilities with:

(a) Fewer than 26 beds, the annual license fee shall be $750.

(b) Twenty-six beds or more but fewer than 50 beds, the annual license fee shall be $1,000.

(d) One hundred beds or more but fewer than 200 beds, the annual license fee shall be $2,900.

(e) Two hundred beds or more, the annual license fee shall be $3,400.

(8) For ambulatory surgical centers, the annual license fee shall be $1,000.

(9) For birthing centers, the annual license fee shall be $250.

(10) For outpatient renal dialysis facilities, the annual license fee shall be $1,500.

[(10)] (11) During the time the licenses remain in force holders thereof are not required to pay inspection fees to any county, city or other municipality.

[(11)] (12) Any health care facility license may be indorsed to permit operation at more than one location. In such case the applicable license fee shall be the sum of the license fees which would be applicable if each location were separately licensed.

[(12)] (13) Licenses for health maintenance organizations shall be obtained from the Director of the Department of Consumer and Business Services pursuant to ORS 731.072.

Approved by the Governor April 23, 2001

Filed in the office of Secretary of State April 23, 2001

Effective date January 1, 2002

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